Kidney Stones - Treatment

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Phosphate compounds:

• Neutral (nonacidic) sodium or potassium phosphate (such as K-Phos, Neutral, and Neutra-Phos) is usually taken four times a day after meals to prevent kidney stones, unless otherwise directed by the doctor. Diarrhea is a possible side effect.
• Cellulose phosphate (Calcibind) is recommended only for severe hypercalciuria that is associated with recurrent calcium stones and caused by excessive absorption of calcium from the intestines. This drug may increase oxalate levels and decrease magnesium levels, which can lead to different kinds of stones. Taking magnesium supplements and reducing dietary oxalates, calcium, and ascorbic acid may help offset these risks. Cellulose phosphate may also cause bloating.

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Avoid acidic forms of phosphate, because they increase the risks for both hypocitraturia and hypercalciuria.

Cholestyramine (such as Questran and Questran Light) is a drug used to reduce cholesterol levels. However, because it binds with oxalate in the intestine, it is also used to reduce high oxalate levels in urine (hyperoxaluria). The drug usually comes in a powder that is dissolved in liquid. Bloating and constipation are common side effects of this drug. Cholestyramine also interferes with other medications, including digoxin (Lanoxin) and warfarin, and it may contribute to calcium loss and osteoporosis. In order to prevent such interactions, take other drugs 1 hour before, or 4 - 6 hours after taking cholestyramine.

Long-term use of cholestyramine may cause deficiencies of vitamins A, D, E, and K. Vitamin supplements may be necessary.

Medications for Uric Acid Stones

Sodium Bicarbonate. Patients whose persistently acidic urine causes uric acid stones may take sodium bicarbonate to reduce urine acidity. Patients taking sodium bicarbonate must test their urine regularly with pH paper, which turns different colors depending on whether the urine is acidic or alkaline. Too much sodium bicarbonate can cause the urine to become too alkaline. This increases the risk for calcium phosphate stones. Patients who need to reduce the amount of sodium they take in (as a result of other medical conditions) should not use sodium bicarbonate.

Potassium Citrate. Potassium citrate, which restores citrate to the urine, is useful for patients with high levels of uric acid in the urine.